Provider Demographics
NPI:1952183063
Name:HASSAN, ALIYA SHARIF (RN, CLC)
Entity Type:Individual
Prefix:
First Name:ALIYA
Middle Name:SHARIF
Last Name:HASSAN
Suffix:
Gender:F
Credentials:RN, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 AUTUMN LN
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-1642
Mailing Address - Country:US
Mailing Address - Phone:617-799-9261
Mailing Address - Fax:
Practice Address - Street 1:6 AUTUMN LN
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-1642
Practice Address - Country:US
Practice Address - Phone:617-799-9261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2264471163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant